- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $27,542.29 / $35,481.34
| Facility | | $18,620.87 | $27,542.29 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $11,748.98 / $25,118.86
| Facility | | $6,309.57 | $11,748.98 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,489.63 / $24,547.09
| Facility | | $9,772.37 | $13,489.63 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,489.63 / $24,547.09
| Facility | | $9,772.37 | $13,489.63 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $16,982.44 / $27,542.29
| Facility | | $5,370.32 | $16,982.44 | $27,542.29 |